Monthly Archives: August 2007

Boredom…

No big news over the last few days.  I’m officially off of the pain medicine as of two days ago, and even though there is occasional significant pain from the main incision I’ve been doing just fine.  FINALLY able to sort-of sleep on my sides, which has been significant.  Having to sleep on my back was driving me insane.  I’m getting around very well, spent part of today getting my stereo hooked back up….only to find out my crappy CD player needs replaced.

 Anyway, no sense in rambling, I was going to the movies this morning and slept in, so I’ll do my big post-surgery driving debut tomorrow morning when I go see Halloween and sneak into Death Sentence.  I guess the fact that there is NOTHING on the AMC concession menu I can eat is a financial blessing…I’ll have to go and pick up some fancy Fiji water beforehand to compensate.  As far as food, it has pretty much been cottage cheese, eggs, string cheese, and one piece of fish the other night.  I’m still struggling with feeling out what “full” feels like, but since I can only really have a few bites at a time I’m not lamenting the boring food choices yet.  The weather has really let up, so maybe I’ll go wild at some point and take the dog down to the riverwalk….

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Egg Day!

Actually, yesterday was egg day.  After an afternoon at the doctor’s office getting my staples taken out, and having my mother cart me around to run a few errands, I was pretty wiped out.  Yesterday morning I did enjoy the perfect marriage between a Campo Lindo egg and a small bit of Shatto Farms butter.  Scrambled, nothing fancy.  First of all, who in the hell has a clue about how ONE egg even looks like in a pan?  Damn it cooked fast.  Anyway, that was one wonderful egg.  After a week of clear liquids, it was a welcome break.  I had another one this morning.  It’s kind of a Zen thing to get everything ready to cook one single egg, put it on the plate, sprinkle a tiny bit of kosher salt on it, then sit down and consume it slowly.  Then that’s it…….no bacon, no toast, no slamming down a quart of orange juice……breakfast is over.  It’s not a bad or depressing thing, it is just so much different than I thought it would be. 

I think I’m starting to learn what everyone meant when they said it could take at least three months to adjust to the changes.  Having to re-learn what “full” feels like isn’t going to be a small task.  For example, I’ve heard people say at least fifteen times “now on egg day, you won’t even be able to eat the whole thing”.  I definitely ate the whole thing.  I ate it and I wished I could have had about five more.  I guess the new stomach was full, but the disconnect between what your body knows and what your brain thinks is going to be a huge hurdle to overcome.  I can recognize what I believe are the telltale signs (I’ll have to ask others who have had the surgery) of my stomach being “full”…..a little bit of tightness, the feeling that I might be about to burp but I don’t…..but that in NO WAY keeps the brain from flipping out every time a stupid KFC commercial comes on, or I’m watching Tony Bourdain chow down with a Ramone.  It is totally possible to be “full” now and still have the brain make me salivate and try to trick me into thinking my stomach is going to start growling (which it doesn’t anymore, a strange thing in itself). 

I’m not really distressed about this or anything, it’s just going to be a big learning curve.  Today has been better than yesterday, and yesterday will be better than today.  I knew it was coming, but it was like so many things taken as some kind of disclaimer from doctors and professionals…”it could take you three months to readjust”…..yeah yeah, whatever……holy shit, in this instance they weren’t kidding. 

Other than that, someone needs to create chewable vitamins that don’t taste like a sandy, chalky piece of lab created lemon rind.  And that bastard of an incision is giving me a break, I’m almost beyond needing any pain meds.  I really need to try and drive in the next couple of days…just getting out of the house to get gas will be like an adventure. 

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Damn I’m Hungry…

I’m definitely looking forward to “egg day” tomorrow.  I’ll get a glorious egg for one of my meals (jello and broth for the other two), and in the following days I’ll swap out another egg for the liquids until I’m totally on protein.  Something curious has happened in the past day…I think it is a combination of lack of real nutrition and the lifelong ability to act on the urge to eat. Anyway, when I’m watching FoodTV or some of the food commercials I start getting really anxious and feel like I’m hungry.  THEN when I flip the channel and chill out for a few minutes I’m okay.  I’m sure there are doctors and psychologists that could speak to this much more effectively than me, but it’s interesting to see the whole Pavlovian thing happening post-surgery.  I don’t get depressed or upset that I can’t have the food, I just start thinking about my empty belly and the mind takes over.  I will be VERY interested to see if the same thing happens once I’m on a diet of solid proteins and am reaping the benefits of constant satiety.  One thing at a time…I don’t want to start lamenting a life of food obsession and obesity driven by the attachment to TV, I just want to make it to egg day so I can chew something.

 Other than that, I’m getting around much better. The pain meds still help a lot.  It’s still just the one incision site that is giving me the most trouble, but I’m getting around much better every day.  The most important thing for me has been to stick to a schedule of shaving, brushing my teeth, showering, changing my dressings and putting on totally fresh clothes every day.  It may sound like a small thing, but I’m just more focused once I’ve done the daily basics.  You know, focused on things like….which DVD do I watch next, which of these protein drinks tastes the LEAST shitty, were Bill Mahr and Bill O’Reilly separated at birth, how does Swanson get away with selling this beef “broth” when this “faincy” organic stuff is so much better…….all of the important issues.  I have had some friends stop by and visit, which has helped considerably.  

Off to watch The Black Sabbath Story, Volumes 1 and 2…….

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Got Home Tuesday Night…

Everything went really well, although I did underestimate the unpleasantness of a hospital stay of any length.  I won’t be able to write at length until the pain from the various incisions is more under control, but overall I’m very glad to be through the surgery and back home.  Most annoying thing about hospitals….being in intense pain and still having to move around despite being hooked up to a ton of different shit.  IV’s, catheter, drain tubes, pressure boots……I’m sure I’m leaving something out.  Thankfully I was pretty loopy for the first twenty or so hours after surgery, so a lot of it is just a blur.  The “swallow test” (insert joke here) that you have to do the day after surgery was probably the most annoying part of the process.  Basically they raise and lower you on an x-ray table and make you drink a nasty liquid that can be viewed on the monitor, to make sure your new plumbing is working correctly.  I have a huge problem with vertigo, so being on that table was far more agonizing than anything to do with the actual surgery.

 Not much to add about food at this point…I’m on a steady diet of water, sugar free jello, broth and protein drinks.  I haven’t gotten used to knowing “when I’m full” yet, but anything more than a swallow or so makes my stomach feel pretty tight.  Getting around is still kind of tough, even with the hydrocodone I’m taking.  There are a total of six or seven small incisions, the largest of which is of course causing me the most pain.  No sleeping on my side yet, which means I’m only getting twenty minutes of sleep at a time.  Getting up and down is a challenge, but nothing too dramatic. 

More updates later, I just wanted to get something written down since I got home almost 2 days ago.  Back to some major Netflix fun and the occasional shot of sweet pain medicine……

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Uninspired a few hours out….

Well, surgery will begin in about ten hours…or much later depending on how things are swingin’ at the hospital.  Nothing too profound to share at this point.  I’m not overly nervous or reflective.  I think the one thing that will take the most getting used to will be the inability to drink liquids quickly.  Sipping vs. guzzling…and there’s nothing like guzzling some water on these hot summer days.  I’m sure I’ll get used to it like anything else, but just for the hell of it I’m going to chug some water just before midnight (no liquids or anything after that).

 Dinner last night was kind of uneventful.  A few ravioli and some garlic bread.  I stuck with the “easily digestible” recommendation in the surgery checklist.  Light breakfast this morning, and then around 1pm this afternoon was my wonderful bottle of magnesium citrate.  That definitely gets the system moving….and then some.  SO I guess I’m going to get a few hours sleep and get to the hospital in the a.m.  I’ll be back to my rambling once I’m on a wonderful regimen of painkillers…….

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Final Doctor Visit

Yesterday’s visit to the doctor went very well.  It was my “final pre-op” visit, just to go over any last questions, sign the necessary release forms, etc.  I’ve done a lot of homework up to this point, so my only question had to do with my sleep apnea.  When I’ve lost weight in the past, the pressure on the c-pap caused me to swallow a lot of air and wake up with my stomach killing me, spending the next minute or so expelling one huge sustained burp.  Apparently this won’t be a danger post-op, I’ll just have to have the pressure adjusted as needed. 

I’ve done so much homework and worrying up to this point that I haven’t taken any time to really be excited about what’s going to happen.  I worry, that’s what I do.  I worry, analyze, dissect, plan, think, rethink everything until it is over with, rarely taking time to stop and enjoy where I’m at.  This process if of course no exception, in fact, it has been the height of my meticulous illness.  Of course it begs the question…if I can be in control of so many things, why not my weight?  I wish I knew.  The only thing I can compare it to is someone who follows ANY self-destructive path with full awareness…whether it’s alcohol, drugs, gambling or the myriad other bits of our culture that some people can handle in moderation and some people cannot.  Anyway…yesterday I finally took a few minutes to think about the positive changes that this drastic measure will bring.  My doctor laughed when I said I hadn’t really thought about all of that too much, and he reminded me that I’ll probably drop about fifty pounds in the first month.  I think of it like this…all of my clothes will be extremely loose five weeks from now.  I have a lot of work to do in order to make the process successful, but that is a radical change.  They also took my “before” picture yesterday, and will take another one in a year.  So what will a year bring? 

Tonight is the “last supper” at Bluestem…I’m looking forward to that.  I know it probably sounds like the group of drunks who take their friend out for one last bender before court mandated rehab, but I don’t care.  I’ll cap off my love for fine dining tonight, and see where I’m at six months from now. 

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The Basics

Okay, one week from now I should be awake from the procedure and enjoying the nice morphine drip.  I thought that it might be nice to include the pre-surgery basics here for anyone who might be interested.  These are the steps you go through to prepare for surgery, and I highly recommend finding a doctor that includes at least this much homework prior to working on you…… 

Orientation and Insurance  

I’m guessing that most surgeons will have some sort of meet n’ greet like I attended……mostly for some basic education about the surgery options, and to give you some idea about how your insurance is going to react to you trying to get them to pay for bariatric surgery.  I started this whole process in November of ’06, thinking at first I was going to do lapband.  Due to the fact that my insurance will not pay for surgery if you are over a certain BMI, and after doing some research on the lack of success that males 100+ pounds overweight experience w/lapband, I switched to the “permanent” gastric bypass procedure.  I took an extra couple of months to make sure I was comfortable with my decision, so naturally it took longer for me to go through the insurance approval process.  Count on at least six months from the time you decide to have surgery to the surgery itself.  It’s not a fast process, and it shouldn’t be. 

Psychological Evaluation 

Do not underestimate the necessity of visits with the psychologist.  I was shocked to see how many people during my orientation balked at this……”well I’ll just go to Monterrey Mexico and have it done”….etc.  I don’t understand how anyone could approach such a life altering surgery without considering the emotional and psychological ramifications.  Surgery is just a tool to facilitate your weight loss…….I’m guessing that longterm success will be about 90% mental.  Anyway, I’m happy that I was able to talk through a lot of my own demons with a professional up to this point.   

Dietician 

This part of the process is just learning exactly what you can and can’t eat after surgery, the importance of a lifelong vitamin regimen, etc. It’s the roadmap, if you will, that you will follow after surgery.  The first week will be clear liquids, second week will begin with eating one egg, and so on.  I don’t want to say that the education is kind of a scare tactic, because that is a bit strong, but it is definitely a reality check for what the rest of your life will be like.  Seeing the visual that your stomach will be about the size of an egg, and realizing you’ll never be able to guzzle water after mowing the lawn, puts things into perspective. 

1st Preop Consultation 

This is the first time you sit down with the surgeon for any length of time and talk about the process.  More importantly, this is where you actually get your surgery date.  Write down as many questions or concerns as you can possibly think of to bring to this appointment.   

Preop Lab Work 

Just a standard blood test.

 Pulmonary Clearance 

This is basically a couple of chest x-rays and breathing into a spirometer.  It is important that your lungs are in good shape right after surgery to avoid things like pneumonia. 

Cardiac Clearance 

EKG, stress test, etc.  This is a much longer appointment….up to three hours.  One piece of advice I’d give anyone going through this process is to ask any of the supporting staff exactly what is going to happen during the visit, and approximately how long you should expect to be there.   If you don’t know you’re going for a stress test and show up in nice clothes, or you don’t realize you’ll be gone for the rest of the afternoon…..that could cause some undue stress.  I think many doctors/nurses assume you know what’s coming….so be sure and ask.   

Preop EGD 

Since your stomach won’t be seeing food again, the doctor needs to go down there and take a look at it.  I don’t remember anything about this procedure because I was out cold, but it’s your run of the mill tube camera down the throat. 

Blockage Checks 

From my research, I think this step in the process was unique to me.  At least I hope it was.  I keep forgetting to call my surgeon to make sure this was supposed to happen.  When I was leaving the hospital after one of my visits, a guy in a lab coat approached me in the parking lot “because they forgot something”.  He explained that it was important to check for any colon blockages or irregularities, and proceeded to walk me over to a van.  This is where it gets weird.  He had me drink a Dixie cup full of something he said would help “trace” my digestion, and after that I don’t remember anything.  I woke up in a wheelchair in the corner of the parking lot about thirty minutes later, with my pants around my ankles and my ass killing me….I mean just KILLING ME.  I haven’t gotten any bills for the procedure yet, and he didn’t even take my insurance information, so I’m not sure where to start with this one.  I’m serious, I was eating ice cream and sitting on a donut for about ten days after this.    

Preop Education Class 

This was really a big help for me.  This is where you go through the very specific details of what will happen to you before, during and after surgery.  Seeing it all broken down into a timeline was a very big stress-reliever for me.  The two days prior to surgery you’re eating a lot less (no food after noon the day before) and consuming magnesium citrate to get the system flushed out, etc..  I was concerned about whether or not I’d be able to take my regular medication after surgery…but apparently unless you’re taking horse pills you’re okay. 

Preop Physical Therapy Class 

Pretty good info about the importance of just moving around after surgery….to cut down on the chances of blood clots, pneumonia, etc.  Also emphasizes the importance of physical activity for the rest of your life.  You’ll be interacting with the physical therapist a lot right after surgery, so they go through all of the post-surgery details with you…..how to sit up in bed and how soon you’ll be up walking. 

Preop Anesthesia Review This is where you sit with an anesthesiologist and review information with them that, up to this point, you have shared with about five hundred different people at various doctor’s offices.  Funny thing is, that sort of thing is what has inspired this blog….if you’ve ever lost a lot of weight you know how flattering it is to explain your sudden weight loss for the first hundred times, and after that it would just be nice to have a place to say….”Thank you for noticing. I’m tired of talking about it, read the goddamn website”.    

2nd Preop Consultation 

This is where I’m heading this afternoon…..this is the last visit with the surgeon prior to surgery.  Last questions, preparation, short term disability discussions…..unless something weird has shown up in the cardiac, pulmonary or blood work, shouldn’t be a problem.    

So here you have a very small snapshot of what I’ve accomplished up to this point.  Other than the apparent anal rape in the hospital parking lot, I have to say that this has been a very smooth process.  I’m pretty nervous and excited about the big day, and hope to include some good information here later. 

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